缺血预处理对大鼠移植肝缺血再灌注损伤的保护作用

Protective Effect of Ischemic Preconditioning on Ischemia-reperfusion Injury of Rat Liver Graft

目的探讨缺血预处理(ischemic preconditioniong,IP)对大鼠移植肝脏缺血再灌注损伤的保护作用。方法采用wistar大鼠原位肝移植动物模型,供肝冷保存时间150min,无肝期14min左右。80只大鼠,配成40对,配对大鼠随机分配到对照组和实验组(IP组),每组20对。对照组获取供肝前仅以4℃肝素生理盐水灌注,后获取供肝并放入4℃生理盐水中保存;IP组获取供肝前先夹闭门静脉及肝动脉,使供肝缺血10 min,再松开血管夹,恢复供肝血供10min,然后以与对照组相同的方法灌注、获取及保存供肝。各组受体的一半(n=10)用于肝移植术后采集标本:另一半(n=10)用于观察肝移植术后生存期。结果IP组大鼠肝移植术后一周生存率、胆汁分泌量高于对照组,血清AST、ALT、LDH、肝组织细胞凋亡及TNF-α低于对照组。结论缺血预处理能降低移植肝组织中TNF-α水平,减少细胞凋亡,从而减轻移植肝的缺血再灌注损伤,改善移植肝功能。

Objective To investigate the protective effect ofischemic preconditioning（IP） on ischemic-reperfusion injury of rat liver graft and its mechanism.Methods Male wistar rats were used as donors and recipients of orthotopic liver transplantation,andthe period of cold preservation and anhepatic phase were 150min and 14 min respectively. 80 rats were randomly divided into 2 groups,control group：Donor livers were fushed through the portal veins with physiclogical saline solution containing heparin only before harvested;IP group：Before donor livers were harvested,the portal veins and hepatic arteries of them were interrupted for 10min, and reflow was initiated for another 10min.Then did as control group.One half of each group （n= 10）were used to take samples,and another half of each group were used to investigate 1 week survival rate of recipients.Results 1 week survival rate amount of bile flow were higher in IP group than those in control group,meanwhile,serum AST, ALT, LDH,apoptosis of sinu- soidal endothelial cell and TNF-α in hepatic tissue were lower in IP group than those in control group. Conclusions IP could reduce the level of TNF-α in hepatic tissue,protect rat liver graft from ischemic-reperfusion injury and improve the function of rat liver graft.